Managing Long Term Sickness Absence

Angela Schettino writes:

Whilst most organisations have developed some form of attendance management system which educates managers and employees on the policy and procedure related to absence from work, the issue of how best to manage long term absence remains one which many employers still find the most challenging.

• How much absence is considered long term?
• At what stage should I get medical consent and advice?
• How long is too long to be absent?
• Can I dismiss a sick employee?
• What can I do about stress and mental health problems?
• Do employees who have been off sick lose their holiday entitlement?

Due to their size, larger organisations can often be flexible about how they cover work when an employee is absent long term. For smaller enterprise, absence of even a couple of weeks can be crippling to the operation and so rapid resolution of cover may be a necessity. It is an important consideration for any business to weigh up the impact of long term absence upfront and encourage good open communication with the employee. This will be key to achieving a mutually agreeable outcome.


How Much Absence is Long Term?

Any absence which exceeds 28 days or 4 weeks is generally considered long term.

• Consider as early as you are notified about a potential long term absence what impact this absence will have in your organisation and begin supportive dialogue with the employee as early as possible. Be clear about the business reasons for any proposed cover and consider your options widely. Smaller organisations should consider contingencies for all key employees and should aim never to be completely reliant on any one individual.

Medical Assessment and Consent

It is possible to request a report from a G.P. however many employers find it more useful to use independent Occupational Health Specialist to assess the employee’s fitness. An employee can be requested to visit a nominated medical practitioner. A GP/ OH Specialist will be able to independently review the condition, treatment, the likely duration of absence and the long-term effect on capability in relation to job performance and attendance at work. You should request consent to assess medical reports from an employee as soon as you receive notification that they are likely to be absent long term and request that they are assessed medically. A sample form to obtain consent is included in the LRA guidance. A link is attached below.

The medical practitioner may recommend one of the following:

• The individual is, in their opinion, fit to return to work.
• There is the potential to offer alternative employment or reduced hours if this would enable the employee to return to work and meets the operational needs of the business.
• The employee is not fit to return to work.

How Long is too Long?

The length of absence which is ‘unsustainable’ for a business is not determined by law and will depend on the particular impact it will have on your operation and sustainability. Any tribunal will consider the ‘reasonableness’ of employer’s actions and expect that the employer has exhausted alternative options prior to going down a Capability termination route.


Formal Meeting

• Conduct a formal meeting either at home or at a mutually agreeable location with the employee. This can be done as early as the end of the four week period or on the 28th day of absence.

Before the meeting:

• Confirm the meeting by sending the Invite to a formal meeting letter including the right to be accompanied. The tone of letter should reflect the desire to support the employee back to work. This should be issued five working days prior to any meeting .
• Ensure that the employee has all the relevant documents such as absence summary information, a copy of the medical consent (if not already issued) and referral forms, any medical reports already received.
• Managers should be thinking in advance of any reasonable adjustments that they may be able to suggest to support the employee.

At the meeting:

Introductions - Make sure that everyone in the room is introduced. Whilst this is a formal meeting, the manager should be thinking about the supportive tone of the meeting.

Purpose - Explain the purpose of the meeting. This is to review the current sick absence(s), the latest medical view (either from medical reports or the employee) and how the organisation can support. The manager should advise that the meeting will be noted.

Current Situation - Ask the employee about their current absence and how they are feeling. Ask if there is a likely return to work date. Ask the employee what they think has caused the condition if appropriate. Ask about the latest view from the G.P, any treatments or medications that they are receiving. Ask whether any progress or degree of recovery has been experienced since the start of the absence.

Day to Day Activities - Ask about how the condition is affecting the ability of the employee to do normal day to day things. Are they able to get about, care for themselves, concentrate, physically coordinate, perceive danger. This should give one perspective on whether the condition is likely to fall under the criteria of disabled. It should also give an indication of adjustments needed to enable a return to work.

Reasonable Adjustments – Ask the employee whether any adjustments might aid a return to work or sustained attendance level going forward. This may range from simple measures such as a ‘buddy’ to support the employee in the early days back to work or attending the office prior to the return to work date to ‘break the ice’ of walking back into the work environment, or more frequent work breaks. Or it could be more formalised measures such a phased introduction in terms of hours of attendance, and role content. These should be carefully detailed with timelines so that expectations are clear. Workplace assessments should be discussed if any modifications to work station or equipment is required. Further training and supervision may also assist.

Future Position/Options – For employees who are frequently absent due to the same underlying condition or disability, the manager should commence (or continue) an Attendance Monitoring plan. For employees who are still absent due to sickness the manager should be asking whether there is a likely return to work date and what the employees opinion is on any future impact caused by the condition such as further absences or restrictions to work.

Alternative roles/Redeployment – The manager should be asking the employee whether they could return to another role on a temporary basis. This is subject to availability.

Early Retirement – Check your pension provider for rules on early retirement. Ensure employee has access to this if this is a potential option.

Ill Health Retirement – If the condition means the employee will never be deemed fit to return to their post, consider first the possibility of re-deployment. If there may be an option for ill health retirement, explore these options and discuss them with the employee if relevant.

Stage 3 hearing – It is important to explain to the employee that should they continue to be on sick absence or have an absence level higher than the business can sustain then a formal stage 3 hearing may be arranged. The manager should advise that this is normally when all other options have been exhausted. The manager should explain that a formal invitation with rights to be accompanied would be sent in advance.

Conclusion – The manager should close the meeting by summarising the agreed actions and advising that these will be confirmed in a letter.

After the meeting:

• Write to confirm the points discussed in the meeting in the Formal Meeting Outcome letter, including when a stage three hearing would be triggered. This is normally within five working days of the meeting.
• Start the Attendance Monitoring Plan if appropriate.
• Arrange for further medical reports / doctors letters.
• Support any return to work by holding a return to work meeting and regularly review progress. Any agreed phased return to work should be supported by a plan.

LRA Advice

Their advice, with regard to long term absence in particular, includes some of the following considerations;

• does the ‘Statement of Fitness for Work’ say that the employee ‘may be fit for some work’? If so, would a phased return – working part-time or flexible hours – help the employee to get back to work?
• in the opinion of the worker’s general practitioner/medical consultant, or of the organisation’s doctor, when will a return to work be possible?
• will there be a full recovery or will a return to the same work be inadvisable?
• could the employee return if some assistance were provided? Could some re-organisation or re- design of the job speed up a return to work?
• is alternative, lighter or less stressful work available, with retraining if necessary
• is there a requirement under the Disability Discrimination Act 1995 to make a reasonable adjustment?

When you contact a GP or consultant for a medical opinion on an employee’s health, make sure you tell them what the employee’s job entails before asking any questions.

Always keep the employee fully aware of his or her position. Knowing there is a job to go back to can help relieve anxiety. In some cases, it may be appropriate to simply keep in touch with the employee and give them the time they need to recover. This is particularly true where there is a possibility that the illness has job related causes.


Can I Dismiss an Employee While on Long-Term Sickness?

• This should be a last resort once all other options have been considered.
• Before making a decision, think about all the factors mentioned earlier – such as reasonable adjustment, flexible working, job design, a phased return to work, etc. You may have to satisfy an employment tribunal as to the fairness of your decision.

‘Getting back to work programme’

Employees need to be reassured that you have given some thought to their return to work. Talk to the employee and their colleagues and work out a ‘getting back to work’ programme. This might involve:

• shorter hours in the first few weeks or flexible hours
• catching up on any new developments within the organisation
• training on new equipment or new processes/procedures
• a friendly chat about what’s been going on at work – for example, any social events they may have missed or that are coming up.

What Can I do about Stress and Mental Health Problems?

Stress and mental health problems are common causes of sickness absence – particularly long-term sickness. Mental health problems can be very difficult to diagnose. They may be caused by stress, by bullying or by depression brought on by a combination of factors affecting an employee at work and at home. Ensure that you have taken steps to assess and act upon any stress related risks to employee’s health. More guidance on how to do this can be found on the HSE NI website.

Try to be understanding. A counsellor can help to explore the deeper emotional problems associated with mental ill health. For further advice on mental health issues contact “minding your head” at:
http://www.mindingyourhead.info/

Holiday Entitlement?

According to a very recent European Court ruling (Spanish trade union case against a group of department stores), in cases where workers fall sick towards the end of the year, and are unable to take all of their annual leave, they can under EU law carry over their unused leave into the next accounting period.

The ECJ has also ruled that the long-term sick have the right to accumulate at least a year of unused annual leave. But the ECJ says the amount is not open-ended and member states can set an upper limit. We await further guidance from national legislators about how this ruling will be locally interpreted.

A link to the ruling is available here:
http://curia.europa.eu/jcms/upload/docs/application/pdf/2012-06/cp120087en.pdf